Translator: Kamile Viezelyte
Reviewer: Giang Pham Depression takes practice. Now, some of you may hear that and say:
"Jessica, that's preposterous. Do you know my boss?
Have you met my ex? Don't you know that mental illness
runs in my family? I don't have to try to be depressed.
It just happens. What I'm saying, is that living well with
depression takes practice. Being productive every day, despite
depression, takes practice. Being a student or an employee with
depression takes practice. I've had experience with depression
both personally and professionally, but before I go there, I want to share
with you a few numbers that illustrate how depression impacts all of us,
as a society. According to the World Health Organisation
by the year 2020, depression will be the second-greatest disability in the
world, second only to blindness. The National Institute of Mental Health
tells us that depression is the number one disability among Americans ages 15-24,
preventing millions of people from being able to finish school
or hold down a job. Psychology today calls it 'presenteeism',
the phenomenon by which companies lose billions of dollars every year in
lost productivity to depressed employees who come to work but don't actually work. All of this means that depression can be
as debilitating as a physical obstacle. For instance, carrying a cane. But, with a visible disability, we assume
it will take practice to cope, including things like physical therapy. Yet when it comes to depression, we think
that a label and medication are enough to cope. Now, I've worked in mental health
non-profit for years. And while I'm thankful for the great
strides we've made with anti-stigma campaigns, it's time
to go beyond getting a diagnosis, into giving people actual coping
mechanisms. Because without coping mechanisms,
we're trapped in a downward spiral. Being depressed leads to falling behind,
falling behind leads to more depression. So let me tell you why I care so deeply
about this cause. I had a happy childhood, I was the
youngest of 15 grandchildren, and we were very close. And yet,
in spite of faith, family, friends, I had these moments of darkness and the
only way I could describe it would be to call them flashes of grey, in an otherwise
cotton candy childhood. I remember my first episode, I was
8 years old, and we were going to school, and all of a sudden I thought, gosh,
all this feels meaningless. Like, I don't know, I just feel like
I'm gonna live seventy years, and die, and go to Heaven, so,
I don't know why we go to school, I don't know why we go to work,
I just feel-- I just feel really empty. And thankfully those moments
were very fast. However, when I became a teenager,
those moments of darkness, they stretched into hours, and hours
became weeks, and sometimes hours and weeks
became months. And during these depressive episodes,
I would have crying spells, I found it difficult to concentrate
on anything, sometimes I did have suicidal thoughts. But just as bizarrely as these depressive
episodes came, they left. And they were replaced with episodes of
genuine stability and happiness, and sometimes highs where it would take me
5 to 6 hours to fall asleep, and I would have extreme outbursts of
artistic creativity, where I could finish a painting that takes 4 weeks to
make in 4 hours. And so, the roller-coaster of mood swings
continued until I had an epiphany when I was 18 years old. I was a freshman in college and a friend
with bipolar disorder committed suicide. This prompted me to research the illness. And everything started to click -
I realised I had half the symptoms of bipolar disorder; it explained the
inexplicable episodes of depression, the highs due to what we now know as
hypomania, where I couldn't sleep and I had racing thoughts. So I saw the campus psychiatrist, who
diagnosed me with bipolar II, and I got a second opinion, which
confirmed the diagnosis. Now, with therapy and medication,
things were much better. But something was missing. What nobody taught me was how to get
stuff done when I was depressed. So, on my own I developed
creative strategies. I graduated from Northwestern University
cum laude with two majors, I competed for Northwestern speech team, I was a state champion, a national
quarter-finalist, a national semifinalist. I also co-founded an organisation to help
depressed students on campus. But bipolar disorder was not my only foe. When I was 19, I was diagnosed with a very
painful polycistic ovarian syndrome. And then when I was 24 years old, an
autoimmune neuromuscular hurricane by the name Myasthenia Gravis
invaded my life. I'll never forget my first episode. I was climbing up this long flight of
stairs at work, this beautiful sunny day, when all of a sudden I couldn't feel
anything below my waist. And so I kept falling, and falling,
and I could hear my high heels tumbling down the stairs. At first I thought, you know, where are my
quadriceps? I know I brought them with me when I left the house this morning. But then, my thoughts turned somber as
students stepped over my limp body, in a rush to get to class. And my mind was screaming 'Get up!' But my body couldn't move.
And I couldn't speak. A few weeks after that, I was diagnosed
and hospitalized in critical condition with Myasthenia Gravis. The doctor gave me a 50/50 shot of living. And that was 7 years ago. So today, I carry a cane for the
Myasthenia Gravis. People often ask me: 'Hey, what's it like
to live with 5 diseases?' And I tell them the truth, I say: 'Well, I
see myself as Rocky and my 5 diseases as Rocky's different opponents.' So, bipolar disorder is Apollo Creed, the polycistic ovarian syndrome is
definitely Ivan Drago, Myasthenia Gravis is Mason Dixon, asthma
is Clubber Lang, and psoriasis is Tommy Gunn. The odds of getting the first 3 of these 5
diseases are 1 in 50 million. And after that I stopped counting 'cos I
just didn't think there was a point. So, every day I wake up in pain and what
I do when I wake up is I play 'Eye of the Tiger', and I put on my
Rocky boxing gloves, and I pray to God for strength to get through another day. Today, I'm a health activist, a writer,
and a speaker, I have my own award-winning blog,
'Fashionably ill', which is about surviving pain with style and humor, and I'm a contributor to several other
websites, including The Huffington Post, MSNBC did a documentary on my life, Psych Central named me a mental health
hero, and right now, I'm really excited about a project I'm working on;
I'm consulting on a project with Rutgers University and University of
Massachusetts medical school. We're developing a program that will help
young adults with severe mental illness finish school and find meaningful
employment. And that's the thing I wanna talk about
today, it's how to get stuff done when
you're depressed. The three themes we're going to address
are proactiveness, urgency and difficulty. So, proactiveness. What does it mean to
be proactive? Do you have a plan for the next time
you get depressed? So, let me give you an analogy: Over the years, my Myasthenia Gravis has
gotten better with medication, physical therapy, nutritional supplements,
practice. But there are still times when, all of
a sudden, I can't feel my legs, or I'll lose feeling in one half of my
body, either the left or the right side. The other day, I was talking to one of my
students, I coach high school debate, and I could sense that I was losing
feeling in my legs. So immediately, I sprang into action. I clutched my cane harder because I knew
what was coming. In the same way, when I sense that I'm
getting depressed, I spring into action. I call my therapist right away, schedule
an appointment, I start exercising more than usual. Because exercise releases endorphins,
the feel-good hormones, that help us fight stress and depression. But, in order to make a plan, you need to
know two things: Your symptoms of depression and the
strategies that work for you. When we usually talk about the symptoms
of depression, it's a generic list. You've probably seen it in a pamphlet or
read it somewhere on the Internet. But the truth is, no two people are
exactly alike. So what are your symptoms of depression? Some people, when they're depressed,
they lose their appetite. Other people tend to overeat when
they're depressed. Some people have insomnia. For others,
they sleep too much. Some people have outbursts of anger; and still, many people with depression
have no temper at all. Know yourself. In addition to knowing your symptoms, you
need to identify now what strategies work for you. So, what do you need when you
get depressed? If it faith, is it family, is it friends,
is it exercise, is it reading, is it listening to music? Identify these strategies now so that
when you see your symptoms, you can spring into action. The other day, my niece gave me a pleasant
surprise visit, and I was really happy to see her. When she hugged me, she said:
'Tita Jessica, did you know you have toothpaste in your hair?' And so I've learned that toothpaste
in hair equals depression. For me, anyway. Know yourself, plan now, don't wait,
be proactive. The best defence is a good offence. In addition to being proactive, we need
to understand the concept of urgency. Urgency is about drowning out wild noise
and focusing on what's the most important. So, let me give you an example
of what not to do. In college I had this class called
'The sociology of crime'. And once in a while, the professor would
show us clips from classic mafia movies, like 'The Godfather' and 'Goodfellas'. And so I had this brilliant plan
for the midterm. I mean, I thought it was a great plan. And I was going to finish reading the
whole textbook, I was gonna review all the lecture notes, and I was gonna
watch all of those mafia movies. So, the test was on a Tuesday. I reserved Sunday for watching
all those mafia movies: 'Godfather', 'Goodfellas', 'Casino'. And Sunday came and went, watched all
those movies, I reserved Monday for reading the
textbook. Monday came, and I woke up depressed. And then I stayed depressed. So, Tuesday morning came, and I hadn't
read a thing. I went into the exam, and for every
question on the test, I kid you not, my answers were: 'Well, in Goodfellas,
Henry Hill, played by Ray Liotta, he did this,' or, 'Lorraine Bracco did
that,' or, 'According to Vito Corleone...' Wouldn't it be great if my professor
rewarded me for temerity of my answers? He didn't. (Laughter) He said while it was great that I had
mastered mafia cinema, he would appreciate it if I read the
textbook next time. So, obviously, if I had to do it all over
again, studying the textbook was a 100, no, maybe a million times more important
than watching 'The Godfather'. Urgency is about being able to understand
what is most important and what is most pressing. So, I keep a daily to-do list. If something's due today, it gets 4 stars,
if it's due tomorrow, 3 stars, sometime this week, 2 stars,
next week, 1 star. And when I'm depressed, I ignore anything
that has less than 3 stars. Urgency is also about being able to say no
to non-essential tasks. So, meeting your work deadline
is essential. The church bake sale is non-essential. When we say yes to everything,
we amplify our stress. One of my friends' mom, a pastor, says: 'If you can't say no, then your yeses
mean nothing.' Third and finally, getting stuff done when
you're depressed is about understanding difficulty. So, when I'm depressed, I label all tasks
as a 1, 2 or a 3. If it's an easy task, it's a 1. Examples include eating breakfast or
taking a shower. If it's a moderately difficult task,
it's a 2, and a 3 is reserved for difficult tasks. For example, finishing a paper in college
or scheduling an appointment with your child's teacher, or meeting a difficult
work deadline. And when I'm depressed, I focus on
finishing all the 1 level tasks first. And every time I cross something off my
list, even if it's taking a shower, I feel empowered and I think: 'Bipolar, watch
out, I'm coming, I got this!' And as I finish off all the 1 and 2 level
tasks, I build the confidence to tackle the 3 level tasks. And you can also help yourself by turning
a 3 level task into a 1 level task. So, I remember a time when I was in my
therapist's office and I told her: You know, I wanna exercise because
experience has told me that when I exercise, I feel better about my
bipolar disorder. But I'm just too depressed to do 30 mins
of exercise right now. And she said to me: If you don't have 30 minutes, can you just
give me 10 minutes? That was life-changing advice. So now I aim for 10 minutes.
And 10 becomes 20. And 20 minutes becomes 30 minutes. Today we've talked about 3 themes in
getting stuff done when you're depressed. They're proactiveness, urgency
and difficulty. Almost always when I use these strategies,
they work. But there are days when the bipolar
disorder or the ovarian disease, or the Myasthenia Gravis, or
all of the above win. And when that happens, I remind myself
of something that I want to share with all of you. I want to share this with anyone
listening, who fights depression, or who loves someone that does. Yes, depression is real. But hope is real. Courage is real. Resilience is real.
all i have to do is limit "stuff i need to do" to sleeping and bam, i accomplished everything i needed to do!
Too depressed to sit through the lecture ...
This lecture just becomes a boasting lecture about how great and wonderful she is